Can Screening For Heart Disease Lead To Prevention And Treatment?

For many years, people have been screened for possible diseases, such as breast cancer, colon cancer, and lung cancer. The screening is done even when no symptoms are present. However, there has been no consensus among cardiologists about whether cardiac disease screening should be done and how effective it is in determining risk of heart disease. This is true despite the fact cardiovascular disease is the number one cause of death among Americans.

A new computed tomography (CT) scan may change this, because it can show even a small buildup of coronary plaques which can restrict blood flow and cause a myocardial infarction. There is now increased interest among physicians in screening non-symptomatic patients. The simple CT imaging technique is called a coronary artery calcium (CAC) scan.

Traditionally, patients have been screened for possible heart disease by using a combination of historical and clinical data and a standard blood test to measure serum lipids and blood glucose levels. However, the risk scores from such screening have been of uncertain value. Increasing data indicates that a CAC scan would be much more accurate for this purpose. The importance of more accurate screening is that it can lead to life-style and dietary changes, as well as medications that can reduce the future risk of cardiovascular disease.

The lead author of the study that found the CAC improved prediction of cardiac risks was Alan Rozanski, MD, director of the cardiology fellowship training program at Mount Sinai Hospital in New York. He stated that “using current state-of-the-art scanners, CAC scans are associated with only very low radiation exposure, similar to that of a mammogram.” He went on to say that “there is increasing interest in determining whether the use of CAC scanning could lead to earlier and more effective treatment of heart disease.”

In summarizing the importance of CAC screening, Dr. Rozanski said that “the CAC score has become one of our most robust predictors of patient risk” and “even a CAC score of one or above is sufficient reason for patients to adopt more heart-healthy behaviors.”